1. Erectile Dysfunction Drug Use Risky Sexual Behavior, and STDs in Men with and without HIV infection
RL Cook, KA McGinnis, DA Fiellin,
JH Samet, JL Goulet, S Crystal
KL Kraemer, C Gibert, AJ Gordon,
M Rodriquez-Barradas, K Mattocks
RS Braithwaite, C Gibert, and AC Justice
VACS Scientific Conference, New Haven, October 2008

2. Introduction
Erectile dysfunction drugs (EDD) are aggressively marketed and often requested.
EDD use has been linked to risky sexual behavior in some groups of men.
We need to know whether persons prescribed EDD drugs are more likely to engage in risky sexual behavior.
HIV-positive men are an important group to consider

3. Objectives
Identify factors associated with EDD use in sexually-active HIV+ and HIV- men
Determine whether EDD use is associated with risky sexual behavior and/or STDs.
Determine whether these relationships differ according to HIV-status or alcohol and drug use.

4. Study Population Veterans Aging Cohort Study (VACS)
3rd follow-up survey
September 2005 – January 2007
3902 men completed the survey.
2788 reported past-year sex activity. .

5. Key Measures
EDD use: received 2 or more prescriptions for EDD in the previous year (based on Pharmacy Benefits Management data)
Risky sexual behavior: having any unprotected intercourse with a non-main partner in the past year.
STDs – any in past year (self-report).
Additional measures
Demographic factors
Alcohol and drug use
Medical comorbidities

6. Results 2788 Sexually Active Men 28% received EDD prescriptions
mean age 52 years
69% black, 18% white, 9% Hispanic, and 4% other race/ethnicity
54% HIV-positive
28% received EDD prescriptions
16% engaged in risky sexual behavior (unprotected sex with non-main partner)

7. Proportion of Sexually Active Men who Received EDD in Past Year

8. Proportion of Men who had Risky Sex

9. Proportion of Men who had STD

10. Factors Associated with Risky Sexual Behavior: Multivarable Analysis

11. Factors Associated with STDs: Multivarable Analysis

12. Subgroup analyses
No substantial differences in predictors of EDD, risky sexual behavior, or STDs when stratified by HIV status, AUDIT >=8, or cocaine/stimulant use

13. Conclusions
EDD use was not associated with risky sex or STDs in this sample
Risky sexual behavior was associated with younger age, MSM, and alcohol and drug use.
STDs were associated with being HIV-positive, younger age, alcohol and drug use, and depressive symptoms

14. Implications
Providers need not be overly concerned about prescribing EDD
Findings different from some previous studies
No significant differences in HIV+/HIV- men
Need to continue to address alcohol and drug use as HIV-prevention measures